Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
Neuralgia possesses no "pathology," if by that word we intend to signify
the knowledge of definite anatomical changes always associated with the
disease, in a manner that we can exhibit or exactly describe. It also
possesses no demonstrable causes, if we employ the word "causes" in the
old metaphysical sense. And yet I am very far from admitting, what seems
to be so generally taken for granted, that we know less about the seat,
the nature, and the conditions of neuralgia than of other diseases. On
the contrary, I believe, with all deference to the supporters of the
ordinary opinion, that we know more about neuralgia, in all these
respects, than we do about pneumonia, only our knowledge is not of the
superficial and obvious kind, but requires the aid of reason and
reflection to develop and turn it to account. It has long been a matter
of surprise to me, that even able writers have been content to talk
about this disease (as, indeed, they have been content to speak of many
nervous diseases) with an inexplicable looseness of phraseology. They
speak of its "protean" forms; whereas, in my humble judgment, its forms
are by no means specially numerous. They insist on the mysterious and
unintelligible manner of its outbreaks, remissions and departure; but I
shall try to show that, although, in the investigation of neuralgia, we
are continually stopped in particular lines of inquiry by what seems to
be ultimate facts, susceptible of no further immediate solution, the
channels of information open to us are so unusually numerous as to
enable us to accumulate a mass of information which, upon further
reflection, will be found to furnish the materials of a synthesis of the
disease singularly clear and effective for every practical purpose of
the physician. In one important particular I especially hope to convince
the reader that a large proportion of the mystification as to the
pathology of neuralgia is gratuitous, and the result of great
carelessness in estimating the comparative value of different facts. I
hope to show clearly that, as regards both the seat of what must be the
essential part of the morbid process, and the general nature of the
process itself, we possess very definite information indeed. I expect,
in short, to convince most readers that the essential seat of every true
neuralgia is the posterior root of the spinal nerve in which the pain is
felt, and that the essential condition of the tissue of that nerve-root
is atrophy, which is usually non-inflammatory in origin. This doctrine
seems, at first sight, presumptuous,[16] in the confessed absence or
extreme scarcity of dissections which even bear at all upon the
question. But one source of the extraordinary interest which the
pathology of neuralgia has long possessed for me resides in this very
fact, that I am convinced we can demonstrate the above apparently
difficult theorem by means of pathological observations on the living
Public-domain text, read in full here on John Shaqi.
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